If you follow this blog at all, you know that our firm represents people who have had life insurance claims denied. You also know that after all these years of practice, we are a bit skeptical about the motivations life insurance companies have for denying these claims.
We know and understand that life insurance companies are for-profit businesses. We also understand that these companies make the most money if they can deny the maximum amount of claims. We don't fault them for trying to run profitable businesses. Where we take issue with them is when they deny claims that are perfectly valid.
In some instances, their denial decisions and the reasoning behind those decisions can be downright cruel. It is in those instances that we get the most satisfaction from our jobs. There is nothing more satisfying than bringing justice to someone who has been wronged. This is especially true in the case of a large insurance company beating up on an individual they believe they can take advantage of.
This article explores one recent case where a life insurer’s decision to deny a claim was beyond all reasonable limits. Fortunately, the beneficiary in that case ended up getting the justice that she deserved. Learn about FEGLI claims
The sad facts
The facts of this particular case are unbelievably sad. The case involved a man named Joe and his beloved wife, Julie. Joe and Julie were the type of couple that everyone wants to emulate. They got married after both had finished graduate school and had what friends described as a storybook romance.
On the night in question, Joe and Julie we're celebrating their 10th wedding anniversary. They had gone out to a fancy dinner downtown and we're headed home early. It's not that they wanted to end their anniversary date quickly, but the couple had a trip planned to Hawaii and their plane left at 5:00 o'clock the next morning. They were anxious to get home, pack, and get some sleep before their big adventure was to begin.
At dinner, Joe had enjoyed three or four glasses of wine. Julie, who was never a big drinker, had only consumed one beer. Consequently, when the couple went to leave the restaurant, Julie decided to drive home.
On the way, the couple had to stop at a drug store for some last-minute items for their trip. This meant Julie had to turn left across a two-lane highway. As she turned, the evening sun was setting just in front of the couple, which made it hard for Julie to see oncoming traffic. In fact, she completely missed a yellow car that was traveling fast in the opposite direction.
As Julie turned, the yellow car struck the couple’s car directly where Joe sat in the passenger’s seat. He was killed instantly. Julie, while severely injured, survived the crash.
The infuriating claim denial
Julie, as you might imagine, was completely devastated by this turn of events. Nonetheless, she had to take care of the administrative tasks associated with Joe’s estate. One of those tasks was to submit a claim for death benefits with Joe’s life insurance company. What happened next shocked everyone.
Joe's life insurance company denied Julie's claim. It did so on the grounds that a life insurance company cannot pay a death benefit to a beneficiary who intentionally killed the policyholder. In essence, the insurer was accusing Julie of murder. The claims adjuster asserted that when Julie turned left in front of the oncoming car, she intended to kill her husband.
Indeed, this was the insurance company’s conclusion despite a comprehensive police investigation that decided: (a) Julie was not intoxicated at the time of the accident; and (b) given the time of day and the way the yellow car blended into the bright light of the sunset, Julie simply didn’t see the oncoming car. The police concluded that Joe’s death was a pure accident.
Nevertheless, the claim denial letter sent Julie into a complete tailspin. She wondered if other people thought she had intentionally killed her husband. For weeks on end, she could barely get out of bed. Fortunately, Joe's best friend was an attorney. He had a colleague who specialized in the wrongful denial of life insurance claims. Together, the two men made it their mission not only to overturn that claim denial, but to make the insurance company pay for its cruel reasoning.
After getting Julie's consent, the attorneys filed a lawsuit against Joe's life insurance company. In addition to a claim for breach of contract, they also asserted a claim for bad faith. That second claim allowed Julie to ask the court to impose punitive damage is against the insurer.
The case went to trial nearly one year later. After hearing the facts , Julie was awarded the full policy benefit plus three times that amount in punitive damages. Although that was illegally sound result, Julie, her friends, and her family were nearly ruined by the insurance company’s accusations.
Sadly, this is not the only case we’ve heard of where a life insurance company accused an innocent beneficiary of murder. Again, they do this simply to avoid paying out a claim. It’s hard to fathom that a couple hundred thousand dollars is worth destroying someone’s life, but it does happen.
If you or someone you love has recently had a life insurance claim denied for any reason, you should talk to an attorney. This is especially true if something about the claim denial reasoning just doesn’t feel right to you. We have a qualified staff of attorneys who would be happy to help you sort it all out.The initial consultation is free. After that, if we mutually agree that your claim should be contested, you won’t have to pay our firm a dime unless and until you receive monetary recovery from the life insurer. As attorneys who practice in this area all the time, we’re sick and tired of seeing life insurance companies get away with these underhanded tactics. Call us today to see if we can help in your situation.